Chinese Journal of Clinical Anatomy >
Application of fibreoptic bronchoscope-assisted nasogastric tube positioning in COPD patients with mechanical ventilation
Received date: 2018-03-24
Online published: 2018-08-21
Objective To investigate the clinical effect of fiberoptic bronchoscope（FOB）-assisted nasogastric tube positioning in chronic obstructive pulmonary disease（COPD）patients with mechanical ventilation. Methods 40 mechanically ventilated COPD patients, enrolled from March 2014 to October 2016, were randomly divided into 20 patients（test group）with FOB-assisted nasogastric tube positioning and 20 patients（control group）with routine indwelling nasogastric tube. Results The indexes, including the first-attempt success cases, the first-attempt success rates, intubation time, number of complications, were significantly better in the test group as compared with the control group， which was opposite case for expenses (19 vs 9, 95.0 vs 47.3, (8.37±1.34) vs (17.9±3.80), 4 vs 12, (262±0) vs (12±0), P<0.05). There were no statistical differences in heart rate, systolic blood pressure, diastolic blood pressure, pulse oxygen saturation, arterial PaO2 and arterial PaCO2 between before and after indwelling nasogastric tube in the test group ((87.7±13.5) vs (89.9±13.8), (114.35±10.6) vs (115.1±9.2), (67.4±14.0) vs (68.7±9.9), (96.9±2.3) vs（97.2±2.2), (88.5±2.2) vs（82.0±19.2), (45.9±18.0) vs (38.4±2.6), P>0.05). Conclusion If the routine method is difficult in COPD patients with mechanical ventilation, it should be replaced by FOB-assisted operation because it is simple , quick, safe and reliable. Furthermore, slight injury can be incurred and high success rate can be achieved.
Key words： Bronchoscope; ; Nasogastric tube positioning; ; Mechanical ventilation
ZHANG Da-cheng , SHAO Jin-lian , CUI Hai-yan . Application of fibreoptic bronchoscope-assisted nasogastric tube positioning in COPD patients with mechanical ventilation[J]. Chinese Journal of Clinical Anatomy, 2018 , 36(4) : 453 -456 . DOI: 10.13418/j.issn.1001-165x.2018.04.022
[1] 王凯权, 陈琼, 任爱华, 等. 重症患者困难胃管置入体会[J].包头医学，2015，39(4)：195-197.
[2] Kirtania J, Ghose T, Garai D, et a1. Esophageal guidewire-assisted nasogastric tube insertion in anesthetized and intubated patients: a prospective randomized controlled study[J]. Anesth Analg,2012,114(2)：343-348.
[3] Zhong N, Wang C, Yao W, et a1. Prevalence of chronic obstructive pulmonary disease in China: a large，population based survey[J]．Am J Respir Crit Care Med，2007，176(8)：753-760.
[4] Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis,Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2016 [S/OL]. (2016-01-05). [2016-06-02]. http://www.goldcopd.org.
[5] Davidson AC, Banham S, Elliott M，et a1. BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults[J]. Thorax, 2016, 71(suppl 2)：ii1-35.
[6] 葛卫星. 经纤支镜引导困难胃管置入体会[J]. 临床急诊杂志, 2011, 12(5):355.
[7] 刘喜成, 杜冬, 吴文燕, 等. 可视喉镜在解剖结构异常的困难气道脑动脉瘤栓塞术患者的应用[J]. 中国临床解剖学杂志, 2015, 33(4): 479-481.
[8] 许和平, 宋维. 经鼻气管插管技术在困难胃管插入患者中的应用[J]. 中国急救医学, 2015, 35(7): 5-6.
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